Evaluation of the knowledge level and usage attitudes of the medical students on the medicinal herbs and herbal products: a project of special study module in the first three years of the school of medicine

Background: In this survey, it was aimed to determine the types of medicinal herbs and herbal products, reasons of use and consciousness levels among the medical students in the first three years of the School of Medicine.Methods: A cross-sectional descriptive questionnaire consisting of 50 questions was applied to all the students in the first three years of Dokuz Eylül University School of Medicine between September 1, 2016 and June 1, 2017.Results: The results of 571 participating students were evaluated. Of these students, 301 (52.7%) were females and 270 (47.3%) were males. It was found that 73.4% (n=419) of the students used these products for treatment and mostly consumed linden, sage tea, mint and rosehip. Also, 11.6% of the students had chronic diseases (n=66). It was determined that 69.7% (n=46) of these students having chronic diseases used medicinal herbs and herbal products. Only 12.0% of the students had an opinion about the legal regulations regarding the use of herbs and herbal products in Turkey, while 39.7% of them had no idea, and 48.3% stated that such regulations on this matter were unreasonable. However, 59.7% of the respondents stated that legal regulations were necessary. It was found that the participating students used herbs and herbal products generally for therapeutic purposes without having sufficient knowledge about medicinal herbs; therefore it was necessary to increase their level of consciousness.Conclusions: Medical students neither have adequate medical information about medicinal herbs and herbal products, nor about the regulations on these products. It is crucial to revise the courses in the medical education so that the students would get informed about the regulations as well as potential risks of herbal plants while still in the medical schools

Enhanced referral prioritisation for acute adult dietetic services: A randomised control trial to test a web-based decision training tool

BACKGROUND & AIMS: Dietitians in acute adult services need to prioritise dietetic referrals in order to manage their daily workload and ensure effective treatment of patients. Newly qualified dietitians do not usually receive specific training on prioritisation and could be helped with an evidence-based, effective, decision-training tool that is based on the practice of experienced dietitians. We developed an internationally available web-based decision-training tool designed to improve novice dietitians' ability to make dietetic prioritisation decisions. The training tool comprised of a pre-training task, a post-training task and training materials. The aim of this study was to test the effectiveness of the training tool on novices' ability for dietetic prioritisation. METHODS: Pre-registration dietitians and recent graduates (one-year) from across the UK were invited to participate in this randomised controlled trial (RCT). Each participant made prioritisation decisions on a set of dietetic referral scenarios: 53 scenarios at pre-training and 27 at post-training. After pre-training the intervention group was presented with the training materials, whereas the control group was told to carry on with the post-training task. Participants did not know which group they had been randomly allocated to. We calculated i) level of agreement between decisions made by each novice and experts' consensus using Pearson correlation, intra-class correlation (ICC(2,1)); ii) intra-rater consistency using ICC(1,1) and iii) intra-group consistency using ICC (2,1). We compared group means at pre-training and post-training; estimated effect size using the degree of change from pre- to post-training, and 2-factor mixed ANOVA to assess overall effect of the training across the groups and time-points. RESULTS: 151 participants (69 in control and 82 in intervention) completed the trial. The groups did not differ in demographic characteristics. Both Pearson and ICC(2,1) correlations increased with training intervention; a moderate effect of training was found for both metrics, d = 0.69 (r = 0.32) for the former and d = 0.54 (r = 0.26) for the latter. Intra-rater consistency improved with training but with a small effect size, d = 0.32 (r = 0.16). The intra-group consistency also improved with training: ICC = 0.48 pre-training to 0.61 post-training. CONCLUSIONS: The training tool was found to be effective in improving the novice dietitian's ability to prioritise referrals in the acute adult setting. The training tool is freely available at www.dietitianreferral.org for use by all student or early career dietitians internationally

A randomised controlled trial to test the effectiveness of decision training on assessors' ability to determine optimal fitness-to-drive recommendations for older or disabled drivers.

BACKGROUND: Driving licensing jurisdictions require detailed assessments of fitness-to-drive from occupational therapy driver assessors (OTDAs). We developed decision training based on the recommendations of expert OTDAs, to enhance novices' capacity to make optimal fitness-to-drive decisions. The aim of this research was to determine effectiveness of training on novice occupational therapists' ability to make fitness-to-drive decisions. METHODS: A double blind, parallel, randomised controlled trial was conducted to test the effectiveness of decision training on novices' fitness-to-drive recommendations. Both groups made recommendations on a series of 64 case scenarios with the intervention group receiving training after reviewing two thirds of the cases; the control group, at this same point, just received a message of encouragement to continue. Participants were occupational therapy students on UK and Australian pre-registration programmes who individually took part online, following the website instructions. The main outcome of training was the reduction in mean difference between novice and expert recommendations on the cases. RESULTS: Two hundred eighty-nine novices were randomised into intervention; 166 completed the trial (70 in intervention; 96 in control). No statistical differences in scores were found pre-training. Post training, the control group showed no significant change in recommendations compared to the experts (t(96) = -.69; p = .5), whereas the intervention group exhibited a significant change (t(69) = 6.89; p < 0.001). For the intervention group, the mean difference compared with the experts' recommendations reduced with 95% CI from -.13 to .09. Effect size calculated at the post-training demonstrated a moderate effect (d = .69, r = .32). CONCLUSIONS: Novices who received the decision training were able to change their recommendations whereas those who did not receive training did not. Those receiving training became more able to identify drivers who were not fit-to-drive, as measured against experts' decisions on the same cases. This research demonstrated that novice occupational therapists can be trained to make decisions more aligned to those of expert OTDAs. The decision training and cases have been launched as a free training resource at www.fitnesstodrive.com . This can be used by novice driver assessors to increase their skill to identify drivers who are, and are not fit-to-drive, potentially increasing international workforce capacity in this growing field of practice

Online training improves medical students' ability to recognise when a person is dying : the ORaClES randomised controlled trial

BACKGROUND: Recognising dying is a key clinical skill for doctors, yet there is little training. AIM: To assess the effectiveness of an online training resource designed to enhance medical students' ability to recognise dying. DESIGN: Online multicentre double-blind randomised controlled trial (NCT03360812). The training resource for the intervention group was developed from a group of expert palliative care doctors' weightings of various signs/symptoms to recognise dying. The control group received no training. SETTING/PARTICIPANTS: Participants were senior UK medical students. They reviewed 92 patient summaries and provided a probability of death within 72 hours (0% certain survival - 100% certain death) pre, post, and 2 weeks after the training. Primary outcome: (1) Mean Absolute Difference (MAD) score between participants' and the experts' scores, immediately post intervention. Secondary outcomes: (2) weight attributed to each factor, (3) learning effect and (4) level of expertise (Cochran-Weiss-Shanteau (CWS)). RESULTS: Out of 168 participants, 135 completed the trial (80%); 66 received the intervention (49%). After using the training resource, the intervention group had better agreement with the experts in their survival estimates (δMAD = -3.43, 95% CI -0.11 to -0.34, p = <0.001) and weighting of clinical factors. There was no learning effect of the MAD scores at the 2-week time point (δMAD = 1.50, 95% CI -0.87 to 3.86, p = 0.21). At the 2-week time point, the intervention group was statistically more expert in their decision-making versus controls (intervention CWS = 146.04 (SD 140.21), control CWS = 110.75 (SD 104.05); p = 0.01). CONCLUSION: The online training resource proved effective in altering the decision-making of medical students to agree more with expert decision-making

Urinary incontinence and quality of life according to trimesters in pregnancy

Purpose: The aim of this study was investigate the effect on life quality (QOL) of urinary incontinence (UI) according to trimesters in pregnancy

Gebelikte trimesterlere göre üriner inkontinans ve yaşam kalitesi

Purpose: The aim of this study was investigate the effect on life quality (QOL) of urinary incontinence (UI) according to trimesters in pregnancy

Additional file 2: of A randomised controlled trial to test the effectiveness of decision training on assessors’ ability to determine optimal fitness-to-drive recommendations for older or disabled drivers

Example of case scenario. (DOCX 15 kb

Additional file 1: of A randomised controlled trial to test the effectiveness of decision training on assessors’ ability to determine optimal fitness-to-drive recommendations for older or disabled drivers

Cues and Cue levels for guiding fitness-to-drive recommendations. (DOCX 19 kb

Descriptive statistics and mean differences in the DS performance measures along with effect sizes and qualitative inferences.

<p>Descriptive statistics and mean differences in the DS performance measures along with effect sizes and qualitative inferences.</p